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Michael E. DeBakey VA Medical Center - Houston, Texas

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VA Physicians Exploring Effectiveness of Bipolar Disorder Medications

February 5, 2007

HOUSTON - The Michael E. DeBakey VA Medical Center (MEDVAMC) is one of only six sites in United States, and the only VA facility, conducting a clinical research study funded by the National Institute of Mental Health to compare the effectiveness and side effects of two widely used medications for bipolar disorder. The study focuses on individuals, both veterans and non-veterans, over the age of 60 who are currently experiencing an elevated mood and who meet study eligibility criteria.

Bipolar disorder, also known as manic-depressive illness, is a brain disorder causing unusual shifts in a person's mood, energy, and ability to function. Different from the normal ups and downs that everyone goes through, the symptoms of bipolar disorder are severe. The periods of highs and lows are called episodes of mania and depression.

Signs and symptoms of mania include unrealistic beliefs in one's abilities and powers; poor judgment; abuse of drugs, particularly cocaine, alcohol, and sleeping medications; and provocative, intrusive, or aggressive behavior. A depressive episode may be characterized by feelings of hopelessness or pessimism; difficulty concentrating, remembering, or making decisions; restlessness or irritability; chronic pain or other persistent bodily symptoms that are not caused by physical illness or injury; and thoughts of death or suicide.

"Bipolar disorder can result in damaged relationships, poor job performance, and even suicide. But there is good news. Bipolar disorder can be treated, and people with this illness can lead full and productive lives," said Rayan Al Jurdi, M.D., MEDVAMC psychiatrist.

The two drugs being examined in this study are lithium and valproate. Lithium, the first mood-stabilizing medication approved by the U.S. Food and Drug Administration (FDA) for treatment of mania, is often very effective in controlling mania and preventing the recurrence of both manic and depressive episodes. Valproate, an anticonvulsant medication approved by the FDA in 1995 for the treatment of mania, can have mood-stabilizing effects and may be especially useful for difficult-to-treat bipolar episodes. This study is the first effort by clinicians to compare the effectiveness and side effects of these two widely prescribed bipolar medications among the elderly.

"With aging, many people with bipolar disorder continue to experience mood swings and a significant number develop symptoms for the first time. Although effective treatments exist, many times these problems may remain undiagnosed, untreated, or undertreated in the elderly population. With this study, our goal is to provide guidelines for safe management and adequate treatment of this illness among elderly patients," said Mark E. Kunik, M.D., M.P.H., MEDVAMC psychiatrist.

In addition to this clinical study, VA researchers are establishing a database of individuals of all ages with bipolar disorder to facilitate future studies. Interested persons will be asked to sign a consent form and supply basic demographic information in order for researchers to contact them about upcoming studies. Kunik and Al Jurdi are collaborating with Lauren Marangell, M.D., founder and director of the Mood Disorders Research Center at Baylor College of Medicine.

This research study has been approved by the Baylor College of Medicine Investigative Review Board. Participants will be compensated for their time and travel. For a free, confidential bipolar screening or more information, call the MEDVAMC at (713) 791-1414, ext. 2247.

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